Pictures of large medical bills are sometimes shared on social media to show how patients can be blindsided by unexpected costs for care, but as the new year begins, consumers will be offered federal protections to avoid health-care sticker shock.

On Saturday, the No Surprises Act takes effect. Supporters said it will block out-of-network providers from sending large bills to patients who did not choose who cared for them in an emergency situation.

Patricia Kelmar, health care campaigns director for the Public Interest Research Group (PIRG), said getting statements in the mail can be very hard for the many Americans who don't have much in the savings accounts to cover the expenses.

"And when you think about the average out-of-network bill for anesthesia is $1,200, these costs can create a real burden on consumers and can lead to medical debt," Kelmar explained.

She noted under the law, your bill cannot be sent to collections while you have a complaint under review. Groups such as the American Medical Association have sued the federal government, saying while they back the law, they oppose the arbitration process drawn by regulators. And the North Dakota Health Information Management Association worries it could force smaller providers out of business.

The statewide group said consumer protections are needed, but argued the process caters to larger providers who have more patient volume.

Kelmar contends the law is trying to establish reasonable fees based on average contracted rates in a community.

"We're seeing higher-than-average, higher-than-market prices from many specialties that use surprise billing as a way to increase their profits," Kelmar contended.

She added more emergency rooms are being staffed by private-equity firms using contracted specialists.

Groups such as PIRG pointed out while the law will make a difference, they have suggested changes of their own. Kelmar noted the measure addresses air-ambulance service from-out-of-pocket providers, but leaves out ground transport.

"Your ground transportation, the ambulance that we think of when we call 911, those bills from an out-of-network ambulance could still be your financial responsibility," Kelmar cautioned.

According to federal estimates, the law will impact roughly 10 million surprise medical bills each year. Nearly 30 states have similar protections in place, but policy experts say they're often limited in scope. North Dakota is among the states without these protections.

A recent scam using fake Indiana government email addresses is prompting a broader warning to Hoosiers.

The messages claimed to involve unpaid tolls and tricked some people into clicking on links where their personal information could be stolen. Investigators traced the emails to a former state contractor's account which should have been shut down.

Isak Nti Asare, executive director of the Indiana University Cyber Security Clinic, said the breach shows why Indiana must treat cyber defense as essential.

"Cyber security should always be a big thing for us," Nti Asare emphasized. "Not because we're reacting to news of incidents and attacks and vulnerabilities but rather just because understand that in order for us to thrive in the digital age as Hoosiers, we need cyber security."

He added it was not just a contractor mistake; it reflects the need for stronger systems and better planning statewide.

Nti Asare pointed out cyber threats happen constantly, not just when headlines appear. He urged people to stop and think before responding to messages that feel urgent or unusual.

"If somebody bumped into you in the street and said, 'Hey, give me your credit card details.' You would go, 'What?' You'd say, 'OK. Show me a badge. Do you have a warrant?'" Nti Asare explained. "We need to be as cautious as you would be in the physical realm, if not really much more, actually."

Indiana's attorney general urged people to report suspicious emails at IndianaConsumer.com. Experts recommended using multifactor login tools, freezing credit reports when needed and changing passwords regularly.


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Consumer rights advocates are celebrating five bills that passed the First Chamber deadline in Salem, moving closer to becoming law.

The bills are supported by the Consumer Alliance of Oregon, a coalition of 18 advocacy groups spanning housing, health care and other sectors. The bills mark the Alliance's first legislative push to protect Oregonians from predatory business practices.

Daysi Bedolla Sotelo, advocacy and policy strategist for the Oregon Health Equity Alliance, highlighted one bill which would rein in hospital facility fees and require transparent patient billing.

"Right now, you go and seek care and then you get home and get the bill and it's surprising that it could be up to hundreds or even thousands of dollars in facility fees," Bedolla Sotelo explained.

Another bill would bring the state's insurance sector under Oregon's Unlawful Trade Practices Act. The change would help guarantee insurance companies, including auto, health and housing, do not deny claims unfairly. Currently, insurance is the only major Oregon industry not subject to the law.

On a federal level, House Republicans are considering reducing the funding for the Consumer Financial Protection Bureau, the agency responsible for shielding Americans from predatory lending practices and fraud.

Ethan Livermore, economic justice organizer for the nonprofit Neighborhood Partnerships, said Oregon lawmakers need to step up and fill in the gaps.

"With so much uncertainty at the federal level, I think Oregon legislators have a really amazing opportunity to make sure that Oregonians are protected," Livermore contended.

Other bills backed by the Alliance would shield Oregonians from medical debt harming their credit scores and guarantee fair rates when buying a car.

Bedolla Sotelo emphasized since everyone is a consumer, consumer protections should be a nonpartisan issue.

"It doesn't matter where you live, you are being affected by all of these issues," Bedolla Sotelo noted. "Oftentimes, we don't think about them until it happens to us."


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Tariffs are disrupting supply chains from China, making it harder for reusable alternatives to compete with single-use plastics.

Jeffrey Delkin, president of Bambu, an Oregon-based company which has been making plastic-free home goods for 20 years, said the Trump administration's 145% tariffs forced the company to lay off their staff in China and make their U.S. staff part-time. Though Chinese tariffs will now drop to 30% for 90 days, Delkin noted it is still a huge jump from the usual 3.5%.

He fears the tariff roller coaster threatens the company's future as well as the market for plastic alternatives.

"Unfortunately, this is a time where we need more small, right-minded, responsibly operated businesses," Delkin contended. "The current conditions are not helping."

Data show even before the trade war, plastic products faced much lower tariffs than their alternatives. This keeps plastic prices low and makes it harder for alternatives to compete. Delkin added since the oil industry receives large government subsidies, plastic producers are better able to absorb extra costs.

Research shows plastics contain harmful chemicals which leech into food, water and the environment. Emissions created during plastic production also contribute to climate change.

Delkin pointed out the public is still learning about the effects of microplastics on overall health, adding more than 90% of plastic produced ends up in landfills.

"It's that kind of stark reality that encouraged us to do what we do and to really promote renewable materials," Delkin explained.

The plastic market continues to grow despite its harmful effects. In 2020, about 370 million tons of plastic were traded, valued at $1.2 trillion.


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